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NPI Code Detail

MEDICARE: DR. SUNITA KANTAMNENI MD

MEDICARE: DR. SUNITA KANTAMNENI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician32281IA
22084P0804XChild & Adolescent Psychiatry Physician32281IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851329296
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUNITA KANTAMNENI MD
Provider Business Mailing Address
First Line : 2101 KIMBALL AVE
Second Line : LL14
City : WATERLOO
State : IA
Zip : 50702-5063
Country : US
Telephone Number : 319-272-1590
Fax Number : 319-272-1535
Provider Business Practice Location Address
First Line : 2750 SAINT FRANCIS DR
Second Line :
City : WATERLOO
State : IA
Zip : 50702-5644
Country : US
Telephone Number : 319-272-8922
Fax Number : 319-272-8929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2006
Last Update Date : 07/16/2007

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